Drugs Affecting Acid Secretion Flashcards
Which cells are responsible for the production of HCl production?
Parietal cells
Where are stimulatory receptors of the parietal cells found?
The baso-lateral membrane
Give some examples of stimulatory receptors found on the baso-lateral membrane of parietal cells
Acetylcholine receptor
Histamine 2 receptor
CCK-B receptor
What is the machanism of action of PPIs?
Blockage of the H+/K+ ATPase which prevents the synthesis of HCl
When, after commencing PPIs, will the max efficiacy be reached?
Why?
2-3 days after
Delayed as not all of the H+/K+ ATPase are active all of the time
What is the mechanism of action of H2 antagonists?
Blockage of Histamine receptors on the basolateral membrane of parietal cells
Reduced production of HCl
H2 antagonists have a _____ half life.
What implication does this have for the dosing regime?
Short
bd dosage
When treating patients with PPs, that happens to their gastrin levels?
What consequence can this have?
Increase in gastrin levels
May develop gastrinomas
Give some examples of H2 receptor antagonists
Cimetidine
Ranitidine
Give some examples of PPIs
Omeprazole
Lansoprazole
How does GORD treatment differ for patients in primary care in the community compared to patients presenting to secondary care?
Community: step up method
-first try changing lifestyles factors, then: antacidas, H2 RA, PPI
Hospital: step down method
-first try PPI then: H2RA, Antacids, then lifestyle
Barrett’s oesophagus is defined by the transition of _______ epithelium to ___________ epithelium
Simple squamous
Columnar
What is the treatment regime for the eradication of H Pylori?
2 Abx:
Clarithromycin 500mg bd
Amoxycillin 1g bd
+ full acid blockade (PPI):
Lansoprazole 30mg bd
